USE OF OTC PHARMACEUTICALS BY SHIFT WORKERS NEEDS MORE RESEARCH

Shift workers use over-the-counter and prescription drugs to stay awake or fall asleep, but researchers say the evidence behind those practices is weak.

Commenting on the study titled “Pharmacological interventions for sleepiness and sleep disturbances caused by shift work“, Dr. David Neubauer, associate director of the Johns Hopkins Sleep Disorders Center in Baltimore, Maryland, revealed that use of these drugs for this purpose “has been studied to a very limited extent and the studies that have been published mostly have not been of sufficient quality to allow firm conclusions. Considering the large number of people who do shift work, it certainly is unfortunate that minimal research has been performed to offer clinical guidance to address the problems of inadequate alertness or sleepiness.”

Dr. Juha Liira of the Finnish Institute of Occupational Health in Helsinki and colleagues reportedly gathered data from 15 trials involving 718 participants. The trials evaluated the effect of melatonin and hypnotic drugs on sleep after the shift, and the effect of modafinil, armodafinil and caffeine plus naps on sleepiness during the shift.

“They found that taking a nap and caffeine before a night shift may improve alertness, and daytime melatonin may add around 24 minutes of extra sleep during daylight hours, but the evidence is weak,”. “For some workers, modafinil improves alertness at work but carries the risk of side effects like headache and nausea, and rarely a serious skin rash syndrome.”

In general, the authors cautioned, “The evidence was of low quality and mostly from small trials. Both sleep and alertness promoting agents have potentially serious adverse effects. Therefore, we need more trials to determine the beneficial and harmful effects of these drugs.”